CPT® Code 90689

Official Description

Influenza virus vaccine, quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use

Common Language Description

An inactivated quadrivalent influenza virus vaccine (IIV4) is designed for intramuscular administration, specifically formulated to provide protection against four distinct strains of the influenza virus. This vaccine is unique in that it offers active, long-term immunity by exposing the recipient's immune system to modified versions of the influenza viruses. Unlike immune globulins, which provide temporary, passive immunity, vaccines stimulate the immune system to produce its own antibodies, enabling the body to recognize and combat the actual viruses upon future exposure. The manufacturing process of this vaccine involves the use of embryonated chicken eggs, where the influenza virus is cultivated, harvested, and subsequently inactivated using formaldehyde. Following this, the virus is concentrated and purified to ensure safety and efficacy. An adjuvant is incorporated into the vaccine formulation to enhance the immune response, making the vaccine more effective. The quadrivalent formulation specifically targets two different strains of influenza type A and two strains of influenza type B, providing broader protection against circulating influenza viruses. It is important to note that when reporting this vaccine, code 90689 should be used for the 0.25 mL dosage administered intramuscularly, while the actual injection procedure should be reported separately.

1. Indications

The influenza virus vaccine, quadrivalent (IIV4), is indicated for individuals who require immunization against influenza. This includes:

Prevention of Influenza: The vaccine is administered to help prevent influenza infection during the flu season, particularly in populations at higher risk of complications from the virus.
Protection for Vulnerable Populations: It is especially recommended for children, elderly individuals, pregnant women, and those with chronic health conditions who may experience severe illness from influenza.

2. Procedure

The administration of the quadrivalent influenza virus vaccine involves several key procedural steps:

Step 1: Preparation of the Vaccine The vaccine is prepared by ensuring that it is at the appropriate temperature and is well-mixed. The healthcare provider must verify the vaccine's expiration date and ensure that it is the correct formulation for the patient.
Step 2: Patient Assessment Prior to administration, the healthcare provider should assess the patient’s medical history, including any previous allergic reactions to vaccines, current medications, and overall health status to determine suitability for vaccination.
Step 3: Administration of the Vaccine The vaccine is administered via intramuscular injection, typically in the deltoid muscle of the upper arm for adults and older children, or in the anterolateral thigh for infants and young children. The injection site should be cleaned with an antiseptic wipe before administration.
Step 4: Post-Administration Monitoring After the vaccine is administered, the patient should be monitored for a short period to observe for any immediate adverse reactions, such as allergic responses. This is typically done for 15 minutes.

3. Post-Procedure

Post-procedure care involves advising the patient on potential side effects, which may include soreness at the injection site, low-grade fever, or mild fatigue. Patients should be informed that these reactions are generally mild and resolve within a few days. It is also important to instruct patients to seek medical attention if they experience any severe allergic reactions, such as difficulty breathing or swelling of the face and throat. Additionally, patients should be encouraged to maintain their vaccination records and schedule follow-up vaccinations as recommended for ongoing protection against influenza.

Short Descr	VACC IIV4 NO PRSRV 0.25ML IM
Medium Descr	IIV4 VACC INACTIVATED PRSRV FR 0.25ML DOS IM USE
Long Descr	Influenza virus vaccine, quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Influenza, Pneumococcal Pneumonia, Hepatitis B, and Covid-19 Vaccines; Monoclonal Antibody Therapy Product
ASC Payment Indicator	Influenza vaccine; pneumococcal vaccine.
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	none
MUE	1